Abstract
Objectives:
This systematic review and meta-analysis aim to compare the functional outcomes of MSR versus MSE in patients with meniscus tears based on direct comparative studies from the last five years.
Methods:
This systematic review and meta-analysis followed the Cochrane Handbook and PRISMA guidelines. We systematically searched MEDLINE (PubMed), Embase, Cochrane Library, and Web of Science from January 2016 to June 2024. Our protocol is registered with PROSPERO (CRD42024565199). Risk of bias was evaluated using ROB2 and ROBINS-I tools, and evidence was appraised using the GRADE approach. Data were extracted and analyzed using a random-effects model to account for heterogeneity among studies.
Results:
Six studies involving 669 patients met the inclusion criteria. Functional outcomes, including IKDC (MD 8.27, I²=95%, z=1.44, p=0.15) and Tegner score (MD 6.75, I²=85%, z=0.78, p=0.44) showed no significant differences between the MSR and MSE groups. However, the MSR group had a significantly better score in KOOS (MD 23.50, I²=0%, z=8.33, p=<0.001) and Lysholm score (MD 14.14, I²=87%, z=2.63, p=0.009). Both groups demonstrated a similar risk of failure (21.87% vs. 18.81%, I²=0%, z=0.30, p=0.76).
Conclusion:
MSR may offer better patient-perceived knee function and quality of life in specific areas. Both treatment options exhibit a comparable risk of failure, indicating that the choice between meniscus repair and MSE should be individualized based on patient-specific factors and surgeon expertise. Given the improved scores in KOOS and Lysholm, MSR should be considered, especially for patients who prioritize long-term knee health and functionality. However, the similar failure rates highlight the importance of patient selection and surgical technique in optimizing outcomes. Future research should focus on long-term comparative studies to further delineate the benefits and risks associated with each treatment modality.